Numerous risk factors for corneal ectasia

BOSTON — Chronic trauma induced by eye rubbing may be an important potential risk factor for corneal ectasia, according to a surgeon speaking here.

R. Doyle Stulting, MD, PhD, spoke about corneal ectasia and its risk factors in a keynote presentation here at the American Society of Cataract and Refractive Surgery Summer Refractive Congress.

According to Dr. Stulting, both a family history and premature birth could increase patients’ risks. Other probable risk factors include eye rubbing, increased astigmatism and biomechanical instability, while possible risk factors include keratocyte abnormality and the use of mitomycin-C.

“Don’t ignore red flags, especially when there are more than one,” he said. “Some patients will develop ectasia even with normal topographies, even after PRK.”

Dr. Stulting and colleagues at Emory University, Atlanta, recently studied 27 eyes of 25 patients with a mean age of 27.8 years. The researchers had carefully selected patients who had the fewest ectasia risk factors possible. All patients underwent PRK, with a mean predicted ablation depth of 85.3 µm, according to Dr. Stulting.

The researchers found it took an average of 14.8 months following surgery to recognize the onset of ectasia. Also, the estimated incidence was about 1 in 2,500 cases, but that data could be an under- or overestimate, Dr. Stulting said.